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Chronic underfunding was matched with poor and often perverse incentives in the use of funds for services. For greater detail on Russia generally, see, for example, the ZdravReform Russia Country Action Plan, November 1994. {PAGE } !,(3!( !( ! !( *! ,,!?(,, !!! **( ( * ,!; ?1,( 55$1 !* < ! !=* ,!( / () ! {PAGE } Table 1 Data on Tver Oblast and the Russia Federation (1991-1994) 1991 1992 1993 1994 Russia (1994) Category Demographic Population (thousands) 1669.2 1660.5 1656.2 1647.5 148,200.0 % 0- 18 N/A 26.0 25.8 25.6 N/A % 19-64 N/A 59.2 58.8 58.5 N/A % 65+ N/A 14.8 15.4 15.9 N/A % Female 54.7 54.7 54.6 54.6 N/A % Rural 28.2 28.1 28.0 28.2 26.9 Infrastructure Physicians (per 1,000 pop) 3.8 3.7 3.7 3.8 3.9 (1993) Ratio GPs/physicians 21.0 22.0 22.0 21.0 15.0 Hospital beds 13.5 13.1 13.0 12.9 12.2 (1993) (per 1,000 pop) Resource Use Hospital Admissions 21.4 20.0 20.6 21.3 21.0 (as % of pop) Bed Days per Capita 3.7 3.5 3.6 3.7 N/A Occupancy rates 74.7 71.3 75.1 79.4 N/A (as %) Avg. length of stay (days) 17.1 17.7 17.3 17.2 17.0 Contacts (per person per year) N/A N/A 6.4 7.7 8.9 {PAGE } Table 1 Tver Oblast and the Russia Federation (continued) 1991 1992 1993 1994 Russia (1994) Category Patterns of Spending Public Spending Per Capita 165 1842 24,502 138,494 N/A Real Per Capita (CPI) 169 244 324 N/A N/A Per Capita ($US PPPS) 127 87 118 N/A N/A Hospital (%) N/A N/A N/A N/A 69.0 Ambulatory (%) N/A N/A N/A N/A Pharmaceuticals (%) N/A N/A N/A N/A Outcomes Crude Birth Rate (per 000) 10.1 8.7 7.7 7.7 9.5 Crude Death Rate (per 000) 14.7 16.0 19.4 21.0 15.5 Infant Mortality (per 000) 19.6 18.6 21.5 19.5 19.0 Low Weight Births (% <2500 grams) 5.6 6.0 6.0 7.1 N/A Abortions (per live birth) N/A 1.86 1.87 2.0 N/A Death by Cause (per 000,000) Infectious & Parasitic 10.0 11.7 14.7 17.0 N/A Malignant Neoplasms 233.5 234.2 246.0 239.5 206.6 Circulatory System 914.5 992.9 1192.4 1310.9 837.3 Respiratory System 65.7 64.6 98.9 101.1 N/A Injury and Poisoning 173.6 218.0 293.8 337.5 250.7 Life Expectancy (at birth) Males 61.9 60.2 56.7 N/A 58.2 Females 74.2 73.4 71.0 N/A 71.6 __________ Sources: Tver Health Administration, 1995; World Bank, 1995; 1996 {PAGE } !" # $ % %& ' % ' ' & '(' '% % %)*+' ' ' ',% ' '- ' ' '' ' ". 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